FORC Grant Application 2013 Beth Shelley Mike

The Rotary Club of Fair Oaks (RCFO) is pleased to announce grant funding available for programs and projects of nonprofit organizations and schools for charitable and educational activities to benefit children and senior citizens in Sacramento County, particularly in the community of Fair Oaks, CA.

Applications for up to $1,000 are considered three times a year, as follows:

Application Deadlines Awards Announced By October 1st November 25th January 1st February 25th April 1st May 25th

Requests will be considered only if all the following required information is included in the application package:

□ Cover Page □ Answers for Section I. (one page maximum) □ Itemized budget and answers for Section II. □ Signature page

COVER PAGE

1 | P a g e Date of Request: ______

Program Area: ____ Community ____ Educational

Applicant’s Name: ______

Applicant’s Title: ______

Address: ______

City: ______State: ______Zip: ______

Phone: (____)______E-Mail: ______

Name of School or Other Organization (if applicable):

Amount of Request: $______

Make Check Payable To: ______

Please describe how funds will be used (2 sentences maximum):

2 | P a g e I. PROGRAM/PROJECT DESCRIPTION

i. Please explain the need for this program / project.

ii. Describe the purpose and activities of the program or project. Who will benefit from this program / project? How many will be served?

iii. How will you accomplish this program / project?

iv. What are the expected outcomes of this program / project?

v. Do you have plans to continue the program / project? What other resources will you consider to continue the program / project?

What is the starting date of the program / project? ______

What is the ending date of the program / project? ______

II. FUNDING

Please attach an itemized breakdown of the budget for this project, including any additional sources and anticipated expense/proceeds outlays. Include a discussion as to additional sources received/to be received.

Have you or the requesting organization requested funds from the RCFO in the past?

Received any funds or projects supported by RCFO? Please list projects and dates.

Did you submit a final report from prior year’s funding? If not, please submit a final report with this application. Your report should summarize project activities and outcomes, even if the project outcomes did not meet your expectations.

III. ADDITIONAL INFORMATION

Please attach additional information or photos that are relevant to your request.

3 | P a g e IV. ACKNOWLEDGEMENT

I understand that acceptance and receipt of this grant will require that I provide:

1. Periodic written reports documenting the progress, accomplishments and any revised completion dates. 2. Final report of completed project, including copies of receipts. Please consider presenting a final report at one of our Monday meetings (prior arrangements required). 3. Digital photos and/or videos that can be used on the website of the Rotary Club of Fair Oaks.

Signature: ______Date: ______Applicant

Name of School Administrator/Agency Representative: ______

Signature: ______Title: ______

Please send completed application, with signatures, to:

[email protected]

OR Rotary Club of Fair Oaks ATTN: Community Grant Committee PO Box 236 Fair Oaks, CA 95628

Questions? Call Shelley Mathews (916) 671-9715

4 | P a g e FOR FAIR OAKS ROTARY GRANTS COMMITTEE USE

RCFO Committee Approvals:

1. ______Date: ______

2. ______Date: ______

3. ______Date: ______

RCFO Board Approval:

President: ______Date: ______

(2016-17)

5 | P a g e